Doctors Lounge - Hematology Answers
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Forum Name: Hematology Topics
Question: Polycythemia vera
|jwalter - Thu Mar 25, 2004 11:33 pm||
My father has been a patient with PV (polycythemia vera) for nearly 7 years, he will soon be 79 yrs old. Chronic lifelong smoker, recently had CHF (congestive heart failure). Is currently hospitalized after dehydration (thought to be the water pill given for CHF), now has a recurrent fever, is weak, and itching/burning skin (possibly symptoms of the PV) and an infection of unknown origin (increased white blood cell count). After xrays and ultrasounds and one week in the hospital, still no clue. Any thoughts?
|Dr. Jeffrey Gordon - Sun Mar 28, 2004 10:55 am||
Thanks for your question here at The Doctor's Lounge.
The skin findings could be related to the polycythemia problems. Dehydration complicates polycythemia by contracting the volume of blood and thereby secondarily elevating the red blood cell level that can be elevated in polycythemia to begin with. It is difficult to provide you any specific diagnoses about your Father's medical problem without having the benefit of test results and physical examination findings. Infectrious problems do arise in elder people and are not necessarily related to the polycythemia, although they can worsen the polycythemia problem when they do occur. Sometimes primary polycythemia can cause more problems with the bone marrow (where the blood is made in the body) and an acute leukemia can arise. Fevers can occur with this type of bloodprocess, although the majority of primary polycythemia patients do not develop an acute leukemia. The white blood cell count being elevated could be due to a fever, could be due to other "stress" conditions placed on the body by an acute illness or could be part of the polycythemia process.
There are times in evaluating a fever of unknown origin that an Infectious Disease specialist is asked to help. Sometimes a Hematologist is asked to help.
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